Best Botox Eyebrow Lift Injection Patterns, Avoiding Spock Brow & Ptosis

Brow lifts with Botox make patients very happy…when they go well.

But when you cause a ptosis or Spock brow it can quickly turn into a complaint.

In this week’s Aesthetics Mastery Show, Dr Tim shares the injection patterns he uses to achieve beautiful arched brows for his patients, without the nasty side effects.

He also explains the anatomical principles behind why we should choose certain Botox brow lift injection patterns over others.

Let us know in the comments if this helped.

Intro
0:00
How to upgrade your eyebrow lift game? One of the common struggles of new injectors is how to get a brow lift, or at least how to identify those patients who won’t be getting a brow lift before you try. I’ve done videos on this before, and I’ve annoyed a lot of people by explaining all the principles without showing the exact points to inject. This time I will — but there was an important reason why I didn’t in previous explanations. Are you ready? (upbeat music)

1:00
Don’t forget to give the show a like if it helps you. Here are the injection points to create a brow lift. Doing this on all your patients gives okay results for most, but sometimes bad results — too much lift in some, brow drop in others. Every face is different. Despite the idea of a universal pattern, it doesn’t exist. Each treatment must be tailored to patient’s age, muscle strength, sex, eyebrow shape, and desired result.

Brow Lift: Treatment Design
2:00
We need to understand core principles so we can design treatments for any face. These are like Lego bricks — understand each, and you can build a bespoke design. First, the shape of the ideal female eyebrow: medial border aligns from alar base to inner canthus to brow head; tail aligns from alar base through lateral canthus; arch aligns from alar base through pupil to brow arch. The arch’s position helps identify which muscles to keep strong for lift.

How are the muscles used?
3:00
Eyebrow elevators: frontalis (up and lateral). Depressors: corrugator supercilii, procerus, depressor supercilii (medial head down), orbicularis oculi (pulls eyebrow down in multiple directions). The lateral component is most important. Relaxing certain muscles changes balance of forces, shifting eyebrow position.

4:00
Two main botulinum toxin effects: (1) Relax half of a muscle → other half increases resting tone (useful for treating medial frontalis to activate lateral frontalis); (2) Change vector balance between elevators and depressors. Think tug-of-war — we decide which side wins.

How to create a slight brow lift
5:00
Weakest lift: relax orbicularis oculi at tail of brow (4 units) to create slight lift. Increase lift by treating more of orbicularis oculi medially under brow (1 unit, very superficial). This is low risk for eyelid ptosis. More lift: treat medial frontalis to activate lateral frontalis — a powerful technique.

Avoid! Spock brow
6:00
Don’t treat frontalis without glabella complex in most patients, or you risk Spock brow (over-lifted lateral brow with angry expression). Over-treating medial frontalis can also cause medial support loss and angry look.

Brow lift core principles
7:00
Design treatment using eyebrow shape. Important line: alar base → mid pupil → brow arch → hairline. Keep frontalis along this line active for lift. Avoid creating forehead lines by shaping untreated muscle area. Use “cat ears” triangle to keep lateral frontalis active. Leave 2 cm safety zone above orbital ridge to prevent medial brow ptosis.

How to save on Botox costs
8:00
Mark out areas without frontalis muscle to avoid wasting toxin. What’s left is the medial frontalis ready for treatment. Space injections evenly. Toxin spreads ~1.5 cm per point (about marble-sized). Plan symmetrical injections to avoid asymmetrical brows. Glabella and orbicularis oculi injections often align with licensed positions, adding to lift.

The different brow lifts
9:00
Lift levels:

• Mild: 2–4 units at brow tail
• Mild–moderate: more orbicularis oculi coverage
• Moderate: treat frontalis + glabella
• Maximum: medial frontalis + orbicularis oculi + glabella

10:00
To reduce over-lift, add 1 unit at tip of “cat ear.” You can enhance lift later by adding orbicularis oculi treatment at follow-up. First-time treatments are a journey — adjustments are normal. Bonus: description contains link to botulinum toxin patterns with licensed doses and designs. Licensed line-treatment patterns aren’t meant for brow lifts — they may flatten brows. Apply today’s principles to adapt patterns for best results. (upbeat music)

This episode is designed for aesthetic injectors—particularly those in the early stages of their practice—who want to move beyond one-size-fits-all injection patterns and learn how to customize brow lift treatments for each patient. It’s also valuable for experienced practitioners who want to refine their technique, avoid common pitfalls like medial brow droop or the “Spock brow,” and better understand the art-meets-anatomy principles that create natural, balanced results. Whether you’re treating mild lines, aiming for a subtle lateral lift, or planning a maximum brow elevation, you’ll gain practical insights on mapping, dosing, and preserving muscle activity to achieve predictable, beautiful outcomes.

A successful brow lift isn’t about memorizing a universal formula—it’s about mastering the anatomy, understanding the balance between elevators and depressors, and tailoring every injection to the individual’s facial structure and goals. By strategically relaxing targeted muscle areas while preserving key vectors of pull, you can create lifts that look natural, symmetrical, and long-lasting. Precision in mapping, dosing, and depth is essential, as is restraint in your first treatment session, allowing for fine-tuning at follow-up. When done well, brow lifts are not just about elevation—they enhance the patient’s natural expression, restore facial harmony, and deliver results that truly reflect your skill as a practitioner.